Dawaa Reference

Clinical reference

Fetal growth restriction

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Fetal Growth Restriction - StatPearls - NCBI Bookshelf (NBK562268) - https://www.ncbi.nlm.nih.gov/books/NBK562268/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class WD71.03 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • A prior pregnancy with preeclampsia, smoking or substance use, a multiple pregnancy, low body weight, or conception by assisted methods raises the risk
  • Chronic maternal illness such as long-standing high blood pressure, kidney disease, or lupus, and being at either extreme of maternal age, adds risk [hypertension]

Signs — what you find (5)

  • Fundal height should roughly match gestational age in weeks; at 32 to 34 weeks this is about 65 to 85 percent sensitive and 96 percent specific, though maternal obesity or fibroids reduce its accuracy [obesity]
  • An affected newborn weighs below the tenth percentile and looks wasted, with little muscle bulk or fat under the skin
  • A Ponderal Index below the tenth percentile signals fetal malnutrition, particularly in the asymmetric form of this condition
  • Liver enlargement, hearing loss, chorioretinitis, and blueberry-muffin skin spots suggest a congenital CMV infection as the cause [hearing loss]
  • Low-set ears, a cleft palate, an overlapping-finger clenched fist, and rocker-bottom feet suggest trisomy 18 [dysmorphic features]

Tests (7)

  • Ultrasound to check fetal growth is recommended once fundal height is off by more than 3 cm from the weeks of gestation
  • An estimated fetal weight below the tenth percentile should trigger further work-up for growth restriction
  • Head-to-abdomen and femur-to-head circumference ratios on ultrasound help tell symmetric from asymmetric growth restriction apart
  • When estimated weight or abdominal circumference falls below the tenth percentile, amniotic fluid and umbilical artery Doppler studies are recommended next
  • Growth ultrasounds are usually repeated every 3 to 4 weeks to track the fetal growth curve over time
  • Umbilical artery Doppler resistance rises as placental insufficiency worsens, eventually reaching absent or reversed end-diastolic flow as blood is shunted to the fetal brain
  • When umbilical artery Doppler shows flow that is absent or reversed at end-diastole, the risk of death around birth is higher

If not this — what else fits (3)

  • An inaccurately dated pregnancy can look like growth restriction, so confirming gestational age correctly is essential to tell them apart
  • Oligohydramnios and a genetically small fetus are also on the differential
  • A constitutionally small but healthy fetus is told apart from true growth restriction by a slowing rate of abdominal-circumference growth on serial scans plus Doppler and antenatal monitoring

SourceStatPearls "Fetal Growth Restriction" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

A suspected small-for-dates fetus found on clinical or ultrasound assessment; the GP recognises and refers to obstetrics for growth monitoring and delivery timing. - Refer, with advice

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A suspected small-for-dates fetus found on clinical or ultrasound assessment; the GP recognises and refers to obstetrics for growth monitoring and delivery timing.

Cautions
  • RED FLAG - Maternal hypertension or preeclampsia symptoms: assess urgently and refer.
  • RED FLAG - Oligohydramnios (amniotic fluid index < 5 cm or single deepest pocket < 2 cm): assess urgently and refer.
  • Severe growth restriction with reduced fetal movements or abnormal blood flow studies needs urgent obstetric referral.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.